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John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

Healthcare has a major challenge when it comes to the term “Patient Engagement.” $36 billion of government money and something called meaningful use has corrupted the word Patient Engagement. While meaningful use requires “5% patient engagement”, that’s a far cry from actually engaging with patients. Anyone that’s attested to meaningful use knows what I mean.

As we move past meaningful use, what then will patient engagement actually look like?

When I start to think about the future of patient engagement, I’m taken back to my experience with a new primary care provider that’s trying to Restore Humanity to Healthcare (see Restore Humanity to Healthcare part 2 as well). In this case, I’m exploring the idea of unlimited primary care along with a primary care team that includes a doctor, but also includes a wellness coordinator that’s interested in my wellness and not just my presenting problem.

Once you take the payment portion out of primary care, it dramatically changes the equation for me. Gone are the fears of going to the doctor because you don’t want to pay the co-pay. Gone are the days where a doctor needs to see you in the office in order to be able to make money from the visit. With unlimited primary care, an email, phone call or text message that solves the problem is a great solution for the doctor and the patient.

Of course, this model of primary care is only one example of the shift that’s going to drive us to patient engagement. ACOs and value based care models are going to require a much deeper relationship between doctors and patients. Trust me that 5% patient engagement through an online portal isn’t going to be enough in these new models.

Plus, these new models are going to really convert our current sick care system into a true healthcare system. I like to call this new model “Treating Healthy Patients.” Quite frankly we’re not ready for this change right now, but in the future we’ll have to adapt. The biggest change is going to be in how we define “patient” and “healthy.”

The wave of connected medical devices and innovation are going to completely reframe how we look at health. Instead of describing ourselves as healthy, the data will tell us that we’re all sick. We’re just at different points in the continuum of sickness.

In the future, patient engagement will be the key to treating each of us individually. The symptoms will change from coughing and vomiting to 85% risk for diabetes and 76% risk for a heart attack. We thought we had patient compliance issues when someone is coughing and vomiting (ie. something they want to fix). Now imagine patient compliance challenges when the patient isn’t feeling any pain, but they need to change something in order to avoid some major health problem.

I think this describes perfectly why we’re entering one of the most challenging times in healthcare. It’s a dramatic shift in how we think about healthcare and has a new set of more challenging problems that we’ve never solved. One of the keys to solving these new challenges is patient engagement.

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Telemedical treatment has been a tantalizing possibility for many years, for reasons including a failure of health plans to pay for it and too little bandwidth to support it, but those reasons are quickly being trumped by the need for quick, cheap, convenient care.

In fact, according to research by Deloitte, 75 million of 600 million appointments with general practitioners will be via telemedicine channels this year alone.

While one might assume that this influx is coming from traditional primary care practices which are finding their way online, that doesn’t seem to be the case.

Instead,a growing number of entrepreneurial startups are delivering primary care via smart phone and tablet, including Doctor on Demand and HealthTap, which offers videoconferences with PCPs, and options like Healthcare Magic and JustAnswer, which offer consumers the opportunity to get written responses to their healthcare queries from doctors.

Primary care doctors going into direct primary care are also joining the primary care telemedicine revolution; a key part of their business is based on making themselves available for consultation through all channels, including Skype/Facetime/Google Hangout meetings.

To date, most of the thinking about telemedicine have been that it’s an add-on service which is far to one side of the standard provision of primary care. However,with so many consumers paying out of pocket for primary care — and virtual visits typically priced far more cheaply than on-site visits — we may see a new paradigm emerge in which victims of high-deductible plans and the uninsured rely completely on telemedical PCPs.

Rather than being merely a new technical development, I believe that the delivery of primary care via telemedical channels is a new form of ongoing primary care delivery.

It will take some work on the part of the telemedicine companies to sustain long-term relationships with patients, notably the use of an EMR to track ongoing care. And telemedicine PCPs will need to develop new approaches to working with other providers smoothly, as coordination of care will remain important. Health IT companies would be wise to consider robust, unified platforms that allow all of this to happen smoothly.

Regardless, the bottom line is that primary care telemedicine isn’t an intriguing sideline, it’s the birth of a new way to think about financing and delivery of care. Let’s see if traditional providers jump in, or if they let the agile new virtual PCP companies take over.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve always liked the idea of a bad boy EMR list. I’ve called it a meaningful EHR certification before. Or an EMR naughty and nice list. It’s a hard thing to do well…especially if you want to make a business of it.

I’ve posted a number of images lie this before. It’s always interesting to see what they say. This one actually looks like it’s trying to help them meet their MU patient engagement requirements as much as it’s trying to explain the EHR implementation delay. I’ve seen quite a few of these signs in hospitals I’ve visited. Getting patients signed up on the portal is a challenging thing for hospitals.

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